Reconstruction of the Medial Canthus Using an Ipsilateral Paramedian Forehead Flap

Kim, Jin Hyung; Kim, Jeong Min; Park, Jang Wan; Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong

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자료유형: 학술저널

저자정보: Kim, Jin Hyung (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) Kim, Jeong Min (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) Park, Jang Wan (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) Hwang, Jae Ha (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) Kim, Kwang Seog (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) Lee, Sam Yong (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School)

저널정보: 대한성형외과학회 Archives of plastic surgery : APS Archives of plastic surgery : APS 제40권 제6호

발행연도: 2013.1

수록면: 742 - 747 (6page)

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Background The medial canthus is an important area in determining the impression of a person's facial appearance. It is composed of various structures, including canthal tendons, lacrimal canaliculi, conjunctiva, the tarsal plate, and skin tissues. Due to its complexity, medial canthal defect reconstruction has been a challenging procedure to perform. The contralateral paramedian forehead flap is usually used for large defects; however, the bulkiness of the glabella and splitting at the distal end of the flap are factors that can reduce the rate of flap survival. We reconstructed medial canthal defects using ipsilateral paramedian forehead flaps, minimizing glabellar bulkiness. Methods This study included 10 patients who underwent medial canthal reconstruction using ipsilateral paramedian forehead flaps between 2010 and 2012. To avoid an acute curve of the pedicle, which can cause venous congestion, we attempted to make the arc of the pedicle rounder. Additionally, the pedicle was skeletonized from the nasal root to the glabella to reduce the bulkiness. Results All patients had basal cell carcinoma, and 3 of them had recurrent basal cell carcinoma. All of the flaps were successful without total or partial flap loss. Two patients developed venous congestion of the flap, which was healed using medicinal leeches. Four patients developed epiphora, and 2 patients developed telecanthus. Conclusions Large defects of the medial canthus can be successfully reconstructed using ipsilateral paramedian forehead flaps. In addition, any accompanying venous congestion can be healed using medicinal leeches.

#Forehead #Surgical flaps #Leeches #Carcinoma

참고문헌 (8)

참고문헌 신청

Bostwick J 3rd / 1975 / Basal cell carcinoma of the medial canthal area / Plast Reconstr Surg 55:667~676

Onishi K / 2007 / Medial canthal reconstruction with glabellar combined Rintala flaps / Plast Reconstr Surg 119:537~541

Guzel MZ / 2003 / The turnover subdermal-periosteal median forehead flap / Plast Reconstr Surg 111:347~350

Shanoff LB / 1967 / Basal cell carcinoma: a statistical approach to rational management / Plast Reconstr Surg 39:619~624

Mustarde JC / 1991 / Surgery of the medial canthus, in Repair and reconstruction in the orbital region / Churchill Livingstone :255~281